Cardiac Function and Diastolic Dysfunction in Behcet’s Disease: A Systematic Review and Meta-Analysis

Table 1

General study characteristics and major findings.

Number	Author [reference] (country)	Subjects	Age/sex match	ISG criteria	Major results	Notes	BD year (mean)	CAD	Active medications	TTE blind	NOS
1	Yurdakul et al. [15]; (Turkey) 2013	Total: 80; BD: 50	Y/Y	Y	Subclinical left and right ventricular systolic dysfunction in BD patients	—	5.9	N	NA	Y	2/2/3
2	Aktürk et al. [16]; (Turkey) 2012	Total: 70; BD: 40	Y/Y	Y	Increased LA volume and DD in BD patients	Disease duration and CRP levels were predictive	4.9	N	NA	Y	2/2/3
3	Karabag et al. [17]; (Turkey) 2012	Total: 67; BD: 38	Y/Y	Y	More DD and prolonged atrial conduction times in BD patients	—	10.5	N	Colchicine, prednisolone & cyclosporine	NA	3/2/3
4	Cobankara et al. [18]; (Turkey) 2012	Total: 48; BD: 24	Y/Y	Y	Normal LV MPI and increased RV MPI in BD patients	—	NA	N	NA	Y	4/2/3
5	Yagmur et al. [19]; (Turkey) 2011	Total: 59; BD: 32	Y/Y	Y	Significant impairment of mean longitudinal strain and higher DT in BD patients	Elevated NT-proBNP in BD patients	5.37	N	Cardiotoxic medicines excluded. Colchicine	NA	2/2/2
6	Koc et al. [20]; (Turkey) 2011	Total: 62; BD: 31	Y/Y	Y	More DD and larger LA in patients with BD	Increased PWD in BD patients. Disease duration correlated with DD and PWD	5.0	N	Cardiotoxic medicines excluded	Y	1/2/3
7	Kaya et al. [21]; (Turkey) 2009	Total: 80; BD: 30	Y/Y	Y	Similar EF in both groups	Lower heart rate recovery index in BD patients	11.0	N	Cardiotoxic medicines excluded	NA	2/2/2
8	Tavil et al. [22]; (Turkey) 2008	Total: 72; BD: 42	Y/Y	Y	LV MPI decreased in BD patients	No influence of colchicine	2.7	N	Colchicine, prednisolone, azathioprine, salicylates & cyclosporine	Y	2/2/3
9	Ikonomidis et al. [23]; (Greece) 2006	Total: 122; BD: 82	Y/Y	Y	Prolonged IVRT in BD patients	BD patients had impaired aortic distensibility and central augmentation index	10.0	N	Steroids and antihypertensive	NA	2/2/2
10	Yavuz et al. [24]; (Turkey) 2006	Total: 41; BD: 21	Y/Y	Y	LV and RV DD more in BD patients	No association with disease activity or medicine usage	10.0	N	Colchicine, prednisolone, azathioprine & cyclosporine	NA	2/2/2
11	Baris et al. [25]; (Turkey) 2006	Total: 73; BD: 48	Y/Y	Y	More DD in BD patients	DD based on ratio only	8.09	N	Cardiotoxic medicines excluded	NA	1/2/2
12	Bozkurt et al. [26]; (Turkey) 2006	Total: 104; BD: 54	Y/Y	Y	No difference in systolic or diastolic function between the two groups	No difference by TTE technique	8.3	N	Cardiotoxic medicines excluded. Colchicine	NA	2/2/2
13	Tunc et al. [27]; (Turkey) 2005	Total: 46; BD: 26	Y/Y	Y	No difference in diastolic function between the two groups except for increased mitral DT in BD	Increased aortic stiffness in BD patients	7.1	N	Cardiotoxic medicines excluded.; Colchicine	NA	2/2/2
14	Topal et al. [28]; (Turkey) 2005	Total: 73; BD: 38	Y/Y	Y	More DD in BD patients	Diastolic parameters correlated with disease duration	NA	N	Cardiotoxic medicines excluded	Y	2/2/3
15	Ikonomidis et al. [29]; (Greece) 2004	Total: 106; BD: 82	Y/Y	Y	More DD in BD patients	Increased aortic stiffness and diameters in BD patients. Prolonged DT is a marker of vascular complications	10.0	N	Cardiotoxic medicines excluded. Colchicine, prednisolone, azathioprine, cyclosporine & statins	NA	2/2/3
16	Gürgün et al. [30]; (Turkey) 2002	Total: 65; BD: 35	Y/Y	Y	No data on DD given for comparison. General indices similar between two groups	Significant valvular pathology in BD patients. Increased QT dispersion and larger aortic diameter also noted	8.0	N	NA	Y	2/0/3
17	Gemici et al. [31]; (Turkey) 2000	Total: 126; BD: 71	Y/Y	N	Increased DD in BD patients	Increased repolarization dispersion in BD patients. This may be related to DD. DD also related to disease duration	9.6	NA	NA	NA	2/0/2
18	Kirimli et al. [32]; (Turkey) 2000	Total: 53; BD: 28	Y/Y	Y	Increased DD in BD patients	Increased repolarization dispersion in BD patients	11.0	N	Cardiotoxic medicines excluded. Colchicine, prednisolone & cyclosporine	Y	3/2/3
19	Morelli et al. [33]; (Italy) 1997	Total: 60; BD: 30	Y/Y	Y	Increased aortic diameter in BD patients.; Normal ventricular function in both groups	Significant valvular pathology in BD patients. Diameter associated with disease duration.; Did not look for DD	10.0	N	NA	Y	3/0/3
20	Komsuoglu et al. [34]; (Turkey) 1994	Total: 42; BD: 22	Y/Y	Y	Increased DD in BD patients	DD related to disease duration	5.0	N	Cardiotoxic medicines excluded.; Colchicine, steroids, antiaggregant & other anti-inflammatories	NA	2/1/2
21	Calguneri et al. [35]; (Turkey) 1993	Total: 39; BD: 24	Y/NA	N	No major difference in TTE but seen on radionuclide imaging	—	NA	N	Colchicine, steroids, antiaggregant & other anti-inflammatories	NA	2/1/2
22	Özkan et al. [36]; (Turkey) 1992	Total: 135; BD: 65	Y/Y	Y	No difference in TTE parameters	DD not specifically studied	5.7	N		Y	4/1/3

The first section reflects score out of 4 for subject selection, the second section after the forward slash reflects subject comparability score out of two, and the final section after the second forward slash reflects score out of 3 for exposure ascertainment.